Veteran Support Specialist Training Program

Transcription

1 Veteran Support Specialist Training Program MEHUL MANKAD, MD, DUKE PSYCHIATRY / DURHAM VA MC KAREN GOETZ, DUKE UNIVERSITY EPIC

2 Acknowledgements GlaxoSmithKline NC Foundation Duke Psychiatry / Duke Evidence-based Practice Implementation Center(EPIC) Center for Child and Family Health NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, Department of Health and Human Services NC Department of Military and Veteran Affairs

3 Purpose of the VSS Program Empower North Carolina VSOs to help Veterans navigate a complex system of care Provide Veterans in transition with a peer/coach/mentor who has been there. Increase the capability and versatility of VSOs to engage with Veterans to address a broad range of issues and needs I Will Guide the Path

4 VSOs: Theory & Practice VSO Theory VSO Reality Counsels and assists Veterans and their dependents in filing claims for benefits with the USDVA and other federal, state, and local government agencies.

5 The VSS Role What is a Veteran Support Specialist? Veteran who has successfully completed specialized training in Veteran peer support, crisis management, and VA resource navigation to promote quality of life and well-being for Veterans and their family members.

6 VSS Training Program Adapts VSO training to conditions on the ground. Based on the tenets of the Peer Support intervention. Designed to leverage shared lived experience in transitioning from military to civilian life. Provides outreach to Veterans who may benefit from services. Provides engagement, coaching, connection and referrals to Veterans encountering transition issues including substance use and mental health issues. Serves as an advocate to Veterans and family members as they navigate military, VA and civilian systems of resources and services.

7 Content Overview Engagement and Communication Skills Active and Reflective Listening, Motivational Interviewing, Case Management, Self-Care Understanding Conditions Understanding PTSD, Co-occurring Disorders, Military Sexual Trauma (MST), Wellness and Recovery Connect with Resources Finding community-based solutions Making connections with resources

8 Online Module Blocks Engagement Skills 1. Peer/coach/mentor Role & Case Management (including Warm Handoffs) 2. Military Culture 3. Connecting to Resources 4. Reflective & Active Listening 5. Motivational Interviewing 6. Building Relationships/Person First Language 7. Self care/sts Mitigation 8. Mindfulness-based Stress Reduction 9. De-escalation/Planning for Anger 10. Decision-making, Problem Solving, & Conflict Styles Understanding MH Conditions 1. Understanding Trauma & PTSD 2. Traumatic Brain Injury 3. Military Sexual Trauma 4. Co-occurring Disorders 5. Homelessness/employment 6. Suicide 7. Substance Abuse & Recovery 8. Whole Health Management/ Mind-Body Connection 9. Self Help & Advocacy 10. Evidence-based Treatment of Mental Health Issues (what is CPT, PE, DBT, etc.) *coaching into care

9 VSO Feedback on Training 4S s Red Flags OARS Case management Person-first language MST eligibility Suicide Prevention Resources TBI tx options Impact on family/kids Easy and fun! Watch and re-watch Dr M and real world examples Interview style Big concepts in language we use (Mostly) short Self-paced Quality videos Role plays Learning together Immediately using skills on the job Self-care reminders Meeting community resources

10 Progress and Plans Over 80 VSS graduates Plans to continue VSS training on bi-annual basis in with support from DHHS and NCDMVA Opportunities to extend VSS training to NC National Guard, MCOs, and community clinicians

11 Contact MARTIN FA LLS NC DEPARTMENT OF MILITA RY & VETERANS AFFAIRS KAREN GOETZ DUKE UNIVERSIT Y EPIC KAREN.G O ET D U K E. E DU MARTIN.FA LLS@ D OA. N C.G OV

12 Cognitive Processing Therapy Training Program PATRICIA RESICK, PHD, DUKE UNIVERSITY STEFANIE LOSAVIO, PHD DUKE UNIVERSIT Y KAREN GOETZ, DUKE UNIVERSITY EPIC

13 What is CPT? CPT is a time-limited, empirically-supported, cognitivebehavioral treatment. During CPT sessions, the clinician and client collaborate to address the following issues: Educating patients about PTSD and explaining the nature of their symptoms. Helping patients explore how traumatic events have affected their lives. Learning about connections between trauma-related thoughts, feelings, and behaviors. Increasing patients' ability to challenge maladaptive thoughts about the trauma. Helping patients increase their understanding of unhelpful thinking patterns and learn new, healthier ways of thinking; and Facilitating patients' exploration of how each of 5 core themes (safety, trust, power/control, esteem, intimacy) have been affected by their traumatic experiences.

14 Why offer CPT treatment? Brief intervention (12 sessions). Effective across broad spectrum of traumas: military combat, sexual assault, physical abuse, domestic violence, terrorism, even complex traumas. Effective with clients with co-occurring disorders. Studies show that clients who engage in CPT treatment reduce/eliminate PTSD symptoms and that improvements are sustained over time.

15 Other Improvements Depression (Resick, et al. 2002, 2012; other studies) Guilt (Resick et al. 2002; 2012; Nishith, Nixon & Resick, 2005) Borderline personality characteristics (Clarke et al. 2008) Reported health symptoms) (Galovski et al. JTS 2009) Hopelessness (Gallagher & Resick, 2012) Suicidal ideation (Gradus et al. 2014) Anger (Rizvi et al, 2009) Functioning (Wachen et al. 2014) No differences between CSA/CPA history and outcomes (Resick et al. 2014) 15

16 How Does CPT Work? Confront avoidance Experience natural emotions associated with the event Change erroneous interpretations about the event, leading to a reduction in manufactured (thought-based) emotions Clients learn not to over-generalize their thinking about a single bad event to all people, situations, or themselves

17 CPT Training Goals Build clinical capacity to deliver Cognitive Processing Therapy with fidelity. Build organizational capacity to sustain CPT in community-based mental healthcare agencies. Develop coordinated treatment programs to address family mental health needs.

18 CPT Roster CPT Trainees will have the opportunity to be rostered as CPT Providers and be included on the official CPT roster at Rostering requirements include: Identification of appropriate clients for CPT treatment. Expert-led weekly clinical consultation for six (6) months with a 75% or better attendance rate. Active participation in case discussion. Weekly reporting of client measures. Completion of two (2) client cases. Submission of rostering application that includes client measures on all clients enrolled during training period and sample of client worksheets.

19 Cognitive Processing Therapy 32 Agencies 32 Senior Leaders 23% Rural 104 Clinicians 22 Counties 53% 23% Suburban Urban/Metro Over 80% continued delivery after 12 months GOAL?! To roster CPT providers in every county in North Carolina!

20 Contact STEFANIE LOSAVIO, PHD DUKE UNIVERSIT Y STEFANIE.LOSAV I DU K E. EDU KAREN GOETZ DUKE UNIVERSIT Y EPIC KAREN.G O ET D U K E. E DU